Tuesday, September 24, 2013

A week before consumers can begin to purchase insurance through an online exchange, Gov. Pat Quinn’s administration released some information on the rates they will pay.

The rates are 25 percent lower than previous estimates from the U.S. Department of Health and Human Services and generally equal to or less than rates released by other states.
“All health insurance plans offered through the Illinois Health Insurance Marketplace are designed to meet the needs of individuals, families and small business owners across the state,” Quinn said in a prepared statement. “I am happy to say that starting in October, Illinois residents will be able to select a plan that is affordable and meets the health care needs of their families. The number and quality of affordable health plans that will be offered through the Illinois Marketplace is impressive.”

The state’s online insurance marketplace is scheduled to become active on October 1. Residents and small business have until December 15 to purchase coverage that will kick in on January 1.
The plans offer a base level of coverage for 10 service categories, including ambulatory care and prescriptions. The plans that will be offered are then giving a metal ranking, with bronze being the lowest cost plans. Under such bronze plans, consumers would likely pay lower premiums but would have more out-of-pocket costs, such as copayments. Under the higher-premium gold and platinum plans, patients would likely pay less out of pocket. The rates in Illinois will vary across the state. A 25-year-old non-smoker in Peoria would pay $128 a month for the basic bronze plan. That some plan would cost $120 in Chicago, $109 in Rock Island, $147 in Springfield and $173 in Carbondale. A Quinn spokesman said that population density plays a role in the rates. The same coverage would cost $146 in Denver and $167 in Seattle. Costs go up with age, and tobacco users will pay more. A 55-year-old smoker living in Carbondale that springs for silver level coverage could pay up to $652.

Americans who make between 138 percent and 400 percent of the federal poverty level — $15,856 to $45,960 for individuals — will be eligible for federal subsidies that will cut their monthly premiums. Illinois residents who fall below that income level for subsides will be eligible for Medicaid. Those residents can begin to enroll in Medicaid on October 1, and coverage will begin on January 1.
“Today’s announcement by the State of Illinois confirms what many have been saying for years: Obamacare will lower health care costs for millions of families,” U.S. Sen. Dick Durbin said in a prepared statement. “Beginning on October 1, families across the state will be able to pick a health care plan that suits their needs. Dozens of plans will be available. Low-income and working families will be eligible for subsidies to help them cover the costs.” Durbin called on Illinois House Republicans to oppose efforts by their party to defund the Affordable Care Act.

While the rates are lower than expected, opponents argue that if consumers want less costly plans with more limited benefits than what will be offered in the exchange, they should be able to buy them. “The level of choice for the patient and for the consumer is really limited,” said Naomi Lopez-Bauman, director of health policy for the Illinois Policy Institute. She said that young people, who tend to need less medical care, especially should be able to stick with bare bones coverage that can currently cost them about $60 a month. She said that instead of using a “clunky” system such as Obamacare, the government could encourage citizens to purchase coverage by offering a tax subsidy. “You have a young man who could be spending $60 because that’s what he wants and that’s very affordable to him,” said Lopez-Bauman. “Why not just give him the money to go out and pick what best suits him? If you truly want to provide access and affordable health care for Americans, there are much better ways than what is being done right now.” People younger than 30 would still have the option of buying a so-called catastrophic plan under Obamacare, but Illinois has not released rate information on such plans.

Jim Duffett, executive director of the Campaign for Better Health Care, said that the basic plan offered in the exchange has coverage that people truly need, such as preventative care. “I think the essential health benefit package that’s out there isn’t whistles and bells.” He said that while there are few who will need care in all 10 categories, most people would need many of the services that fall under required coverage areas at some point in their lives. “Will a 32-year-old male that’s uninsured, will he need maternity care? No. Will he need something else? Yes.” Duffett’s group is one of many organizations being paid to get the word out about the insurance exchange and help consumers use it when it comes online.

Duffett added that a large portion of young people would be eligible for subsidies that would help to drive down their insurance costs. He said most young adults would probably find that they are paying less for their coverage than they pay for their current cell phone plan. He said that while there are still more details that consumers will need to know when they make their purchases on the exchange, the rates released today are far from the “rate shock” predicted by opponents a few months ago. “It definitely does show that the folks that will be eligible for the marketplace are going to be able to select a plan that is affordable and is going to meet their needs and their family’s needs.”

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